African-American Women: Body Image, Weight, & Depression Open Access

Abstract

Abstract African-American Women: Body Image, Weight, & Depression By Michelle A. Nelson Obesity in African-American women (AAW) has become a disease of epidemic proportions. In addition, disproportionately higher rates of depression have been found in AAW when compared to other groups of women. Cultural factors, body image and depression have been purported to separately influence the weight of AAW. The purpose of this study was to explore the relationship among cultural factors (social organization, biological factors, time and environmental control), weight class and depression in AAW with body image as a moderating variable. The adapted Transcultural Assessment Model was used to guide this study. A descriptive, correlational design was utilized to obtain data from 103 male-female African-American dyads. Measures completed by participants included the Partner Perceptions of a Woman's Weight Scale, Female Perception of Weight and Dress Size Index, Male Perception of Female Partner's Weight and Dress Size Index. Waist-hip ratio and BMI were used as weight indicators. AAW were categorized as normal (n=31), overweight (n=34), or obese (n=37). Findings indicated that obese AAW had the highest motivation for weight loss and lowest levels of self-efficacy for physical activity and diet control, perceptions of body image and male significant other's perception of body image. Normal weight AAW had the highest level of depression. There was an inverse relationship between depression and education, health beliefs about weight and weight control, self-efficacy for diet and physical activity and future time perspective. Body image moderated the relationship between the male partner's age and the AAW's BMI. A positive relationship was found between income and waist-hip ratio. It was concluded that the highest level of concordance satisfaction regarding preferences for the woman's dress size and weight was noted between the group of overweight AAW and their male partners.

Table of Contents

Table of Contents Chapter 1. Introduction...............................................................................1 Statement of the Problem...............................................................1 Conceptual Framework..................................................................4 Overview of the Transcultural Assessment Model..............................4 Conceptual Model of the Study....................................................6 Propositions of the Conceptual Framework.......................................9 Assumptions of the Conceptual Framework......................................12 Significance of the Proposed Study...................................................12 Definition of Key Variables............................................................13 Specific Aims.............................................................................17 Summary...................................................................................19 II. Background The Impact of Overweight and Obesity in the United States......................21 The Impact of Overweight and Obesity in African-American Women...........22 Morbidity and Mortality Related to Obesity..........................................23 Culture.....................................................................................24 Cultural Factors in the Culture of Obesity............................................25 Social Organization Factors.........................................................25 Socioeconomic Status............................................................25 Income..............................................................................26 Education..........................................................................28 Family History of Obesity......................................................30 Environmental Control Variables..................................................31 Partner Perceptions of Weight..................................................31 Health Beliefs about Weight and Weight Control...........................33 Empowerment through Self-Efficacy for Diet and Physical Activity.....36 Biological Variables..................................................................38 Age.................................................................................39 Depression and Overweight and Obesity......................................40 Family History of Depression...................................................42 The African-American Woman's History of Depression...................44 Time as a Variable...................................................................45 Perceptions of Body Image............................................................48 Summary..................................................................................52 III. Research Design and Methods Overview.................................................................................54 Research Design.........................................................................55 Sample Recruitment and Setting......................................................56 Sample Inclusion and Exclusion Criteria.............................................57 Data Collection Procedures............................................................59

Protection of Human Subjects........................................................61 Operationalization of Variables.......................................................63 Anthropometric Measures.........................................................63 Self-Report Measures..............................................................65 Data Analysis.......................................................................71 Methodological Assumptions.....................................................76 Limitations Related to the Conduct of the Study..............................76 Summary.............................................................................78 IV. Results...................................................................................80 Overview................................................................................80 Recruitment and Screening of Participants.........................................80 Data Analysis Procedures.............................................................81 Description of the Sample.............................................................82 Description of Female Participants...................................................82 Description of Male Participants......................................................86 Results of Data Analysis...............................................................89 Aim 1..................................................................................89 Aim 2.................................................................................91 Aim 3.................................................................................95 Aim 4..................................................................................111 Additional Analyses.....................................................................119 Qualitative Comments Made by Participants That Amplify Findings...........129 Summary.................................................................................130 V. Discussion, Conclusions and Recommendations Summary of the Research..............................................................132 Discussion of the Findings............................................................138 Obesity and Depression............................................................138 Implications of the Findings for the Transcultural Assessment Model.......141 Socioeconomic Status...............................................................142 Family History of Obesity.........................................................143 The Woman's Perceptions of Her Body Image.................................144 The Male Partner's Perception of the Female's Body Image..................145 Health Beliefs about Weight and Weight Control..............................146 Self-efficacy Related to Diet and Physical Activity............................147 Time Perspective.....................................................................148 Age and Weight.....................................................................148 Body Mass Index and Waist-Hip Ratio..........................................149 Discussion of Additional Findings....................................................152 Conclusions................................................................................153 Implications for Clinical Practice.....................................................157 Implications for Research..............................................................158 Implications for Policy..................................................................159 Strengths of the Study..................................................................160 Limitations of the Study................................................................161

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School	Laney Graduate School
Department	Nursing
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Women's Studies Health Sciences, Nursing
Keyword	Women Body Image African-American Depression Obesity
Committee Chair / Thesis Advisor	Strickland, Ora, Emory University
Committee Members	Gletsu, Nana, Emory University Gilead, Maggie P, Emory University Scully, Pamela F, Emory University Diiorio, Colleen K, Emory University Giger, Joyce Newman, UCLA

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